A 32 year old patient complains about heartburn and dull pain in the epigastrium that appear 2-3 hours after meal. Exacerbations happen in spring and in autumn. The patient has food intolerance of eggs and fish. Objectively: stomach palpation reveals painfulness in the gastroduodenal area. Electrophasoduodenoscopy revealed a 5 mm ulcer on the anterior wall of duodenum. Urease test is positive. What is the most probable leading mechanism of disease development?

Correct Answer: A

Rationale: The correct answer is A: Helicobacterial infection. This is the most probable leading mechanism of disease development in this case because the patient's symptoms, such as heartburn, epigastric pain, food intolerance, and presence of a duodenal ulcer with a positive urease test, are classic signs of Helicobacter pylori infection. This bacterium colonizes the stomach lining, leading to inflammation and ulcer formation. The exacerbations in spring and autumn could be due to seasonal variations in immune response. Choice B: Dietary allergy is incorrect because the symptoms and findings in the patient are more indicative of an infectious etiology rather than an allergic reaction to specific foods. Choice C: Autoantibody production is unlikely as there are no indications of an autoimmune process in this case. Choice D: Reduced prostaglandin synthesis is not the leading mechanism as the symptoms and findings are more consistent with an infectious cause rather than a deficiency in prostaglandin synthesis.

Correct Answer: C

Rationale: The correct answer is C (coli index of 250 and coli titer of 4). The coli index is calculated by multiplying the number of colonies by the reciprocal of the volume filtered, which gives 2 colonies x (1/0.5 L) = 4. The coli titer is obtained by dividing the volume filtered by the number of colonies, which gives 0.5 L / 2 colonies = 0.25 L or 250 ml. This indicates the concentration of coliform bacteria in the water sample. Choice A (4 and 250) is incorrect because it has the correct coli index but the values are reversed for coli index and coli titer. Choice B (2 and 500) is incorrect as it provides the correct coli titer value but the values are reversed for coli index and coli titer. Choice D (500 and 2) is incorrect because it reverses the values for both coli index and coli titer.

Correct Answer: A

Rationale: Step 1: Poxviruses are indeed DNA viruses, confirmed by scientific research. Step 2: Poxviruses replicate entirely in the cytoplasm, unlike most DNA viruses. Step 3: Cytoplasmic replication is a unique characteristic of poxviruses. Step 4: The replication process of poxviruses in the cytoplasm is well-documented. Step 5: Therefore, option A (TRUE) is correct, as poxviruses replicate in the cytoplasm exclusively.

Correct Answer: B

Rationale: The correct answer is B: K-antigen. H. Influenzae types are classified based on their capsular polysaccharides, which are known as K-antigens. The K-antigen is a major virulence factor and plays a crucial role in the pathogenicity of H. Influenzae. The other options (A, C, D) are not used to classify H. Influenzae types. Vi-antigen is related to Salmonella serotyping, O-antigen is characteristic of gram-negative bacteria such as Escherichia coli and Salmonella, and H-antigen is typically associated with flagellar antigens of bacteria like Salmonella and E. coli.

Correct Answer: D

Rationale: The correct answer is D, Vancomycin, because it is not a beta-lactam antibiotic. Beta-lactam antibiotics contain a beta-lactam ring in their molecular structure, which Vancomycin lacks. Benzylpenicillin, Cephalosporin, and Monobactam all contain the beta-lactam ring, making them beta-lactam antibiotics. Vancomycin belongs to a different class of antibiotics called glycopeptides.